Inconsolable neonate - Answer- hypoxia
Preschooler 3-5yrs likes - Answer- Nightlights + Bandaids
4 Components of the Pediatric Prioritization
... [Show More] Process - Answer- 1. PAT
2. Focused Hx
3. Focused Assessment
4. Assignment of an acuity rating
Pain scale - nonverbal - Answer- Flacc
Pain Scale - 4-7 yrs - Answer- Faces
Pain Scale 8 yrs+ - Answer- Numerical 0-10 scale
PAT Components - Answer- General appearance
Work of breathing
Circulation
0 = Sick
1 = Sicker
2+ = Sickest
Airway Assessments - Answer- Tongue Obstruction
Loose Teeth
Vomit
Secretions
Blood
Edema
Airway Interventions - Answer- Re-position the head to a neural position
Open airway - chin lift, jaw thrust
Suction secretions - avoiding vagal stimulation
Not conscious - consider inserting orophargyngeal airway
Breathing Assessment - Answer- Do I have spontaneous respirations?
What is the rate and depth of respiratons?
Do I have symmetric chest rise and fall?
Breath sounds present, what is their quality?
What is the work of breathing - do I have nasal flaring, retractions, accessory muscle use?
Interventions breathing - Answer- Maintain a position of comfort
Provide supplemental O2
Not breathing adequately - provide bag mask ventilation AND reassess for the effectiveness of breathing
Prepare for endotracheal intubation/RSI
Assessment of tube placement, insert gastric tube to reduce abd distention
Breathing assessment - Answer- Do I have spontaneous respiration?
Do I have equal chest rise and fall?
What is the rate and depth of respiration?
What is the work of breathing - is there any nasal flaring, retractions, head bobbing?
Circulation assessment - Answer- Central and peripheral pulse rate and quality
Skin color and temperature
Capillary refill
JVD and tracheal position - trauma
Circulation interventions - Answer- CPR/ALS
Control obvious bleeding
Obtain IV access
Adminster 20ml/kg fluid bolus and reassessment of circulatory assessment
Administer blood or blood productions
Disability assessment - Answer- AVPU - awake/alert, verbal, responds to pain, does not respond/unconscious
Pupils equal round reactive to light
E - Answer- Exposure and Environmental Control
Exposure and Environmental Control Assessment and Interventions - Answer- Look for obvious skin abnormalities
Sources of heat loss
Apply warm blankets
Provide overhead warming light
warm IV fluids/warmed humidified O2
F - Answer- Full set of vital signs
Family presence
Focused adjuncts
Full set of vital signs - Answer- HR, RR, BP, SpO2, Temp, Weight (kg)
Family - Answer- Identification of family members and their relationship with the child
Needs of the family
Assign a healthcare professional to liaison with family/provide family support
Facilitate family involvement
Focused Adjuncts - Answer- Dynamic cardiopulomonary monitor
BGL
Gastric tube
Urinary cath
Blood samples to lab
G - Answer- Give Comfort Measures
Give Comfort Measures - Answer- Assessment of pain
Facilitate family presence to support the child
Initiate pain management measures - anaglesics, splints, dressings, ice
H - Answer- Head to Toe Assessment
Head to Toe Assessment - Answer- Inspection
Palpation
Auscultation techniques for s/s of illness or injury such as rashes, lesions, petechiae, ecchymosis, tenderness
Reassessment of airway, breathing, and circulatory status
H - Answer- History
MIVT - Answer- Mechanism of Injury
Injuries
Vital signs prior to arrival
Treatments
CIA M Peds - Answer- C - c/o
I - immunizations/exposure to infectious disease
A - allergies
M - medications
P - PMH
E - events preceding - onset of illness, treatments prior to arrival
D - diapers/diet - last PO intake
S - s/s
History - Answer- MIVT
CIA M Peds
Focused Hx
Social Hx
Family Hx
Refer to social services
I - Answer- Inspect posterior surfaces
Inspect posterior surfaces - Answer- inspect and palpate posterior surfaces
log roll to maintain airway and spinal alignment
Normal BP formula - Answer- 90 + (2 x age in years)
Min Sys BP - Answer- 70 + (2 x age in years)
What is the most reliable indicator for pain? - Answer- Self-reporting tools
Flacc - Answer- Faces
Legs
Activity
Crying
Consolable
Croup Intervention - Answer- cool mist/O2
Epiglottis s/s - Answer- High Fever
Sudden Onset
Muffled
Drooling
Stridor
Keep caregiver with the patient! Decrease stress.
RSV - Answer- Low grade fever
Foreign body - Answer- remain with caregiver to decrease stress
bronchiolitits - Answer- Lots of secretions - need for suctioning
RSV is a cause
Apnea
What is considered a fever? - Answer- 100.4 F (rectally)
Fever interventions - Answer- UA
BGL
CSF
Sepsis work up
Dehydration interventions - Answer- 20ml/kg bolus
PO intake 5ml every 2-5 minutes
monitor weight
monitor I/O
Gastroenteritis - Answer- S/S - Vomiting + diarrhea
Contagious - wash hands, teach handwashing
@ Risk for dehydration
Rubella - German measles - Answer- RINK
maculopapular rash with downward progression from the face usually resolving in three days
No fever
Rubella - Measles - Answer- Fever
Red macular popular rash - begins on face and progresses downward
High Fever
Chickenpox - Answer- pruitirc rash
lesions in all stages
begins centrally - spreads to face and extremities
DKA Fluids - Answer- Administer at a slow rate to prevent increased ICP
Intussusception - Answer- currant-jelly stool
severe pain
male infant 3 months to 12 months
dx - CT scan of abd
tx - contrast enema
Absent cremasteric reflex - normal UA - Answer- Testicular torsion
Neonate birth interventions - Answer- Observe
Warm
Dry
Stimulate gently
Marks on self, marks on door - Answer- Chocking game
Hypovolemic Shock - Answer- Volume problem
Causes - V/D, trauma, burns
Loss of preload
Increased HR
Low BP
Cardiogenic Shock - Answer- Decreased cardiac output
Causes - cardiomyopathies
- Answer- [Show Less]